Each week, The CSPH answers questions that have been submitted anonymously through Formspring or other channels. This week’s question is:

Do you have any information on post-ejaculatory illness? My partner suffers from it and it can cause him to have severe migraines, vomit, or just feelings of cloudy-headedness/ listlessness after we finish. Usually, he just stops himself from ejaculating, but recently he has decided that celibacy is the only solution. While I am staying with him, I wish there were a solution for both of us.

The steamy sex scenes of Hollywood would have us believe that every man is dying to have explosive eruptions of semen at any given moment, and that such catharsis leads to momentary bliss, followed by cozy pillow talk or an extra-productive day at the office. Of course, these traditional representations of male sexuality fail to depict the complex biological responses that occur immediately after ejaculation, which, for some, can result in temporary feelings of sadness, exhaustion, and diminished cognitive functioning. Often, men experience a refractory period due to a sudden decrease in dopamine, the chemical in our brain that helps regulate movement, emotional responses, and pleasure. This explains why some guys will simply pass out after blowing their load: all that thrusting, pumping, and releasing of chemicals can take its toll, and the body needs time to recuperate.

Although some degree of apathy and disinterest following ejaculation can be expected, the intensity of the symptoms you describe is a bit unusual. In fact, post-ejaculatory illness—known in the scientific community as Post-orgasmic Illness Syndrome—typically affects less than one percent of the male population. Without knowing the specific details about your partner’s medical history, it’s impossible to give a general reason as to why he is having these symptoms. There could be biological or neurological factors at play that are interfering with sexual performance. Some researchers believe that the so-called “orgasm flu” is an autoimmune response, an allergy to the individual’s own semen. Others believe that intense rebound activity in the amygdala, a marked, sudden dopamine crash, can induce a depressed state following sexual activity. If the symptoms are more generalized, meaning that the nausea and apathy extend beyond the bedroom, this could be a side effect of commonly prescribed medications, such as antidepressants. Abuse of alcohol, and other drugs, can also impact sex drive, energy level, and overall well-being. Regardless of the cause, these issues should be explored and examined by a qualified health-care professional.

While post-ejaculatory illness is a bummer, the good news is that, with some patience and practice, penis-owners can train themselves to orgasm without ejaculating! Even though orgasm and ejaculation often occur simultaneously, they are not one and the same. Orgasm, the apex of arousal, is an experience that is physical, emotional, and energetic; these undulating waves of pleasure can occur even without genital stimulation, or an erection, as our bodies are hot-wired for pleasure in several places, including the prostate, anus, and nipples. Ejaculation, however, is a local, genital release controlled by the pelvic muscles, which, for men, often occurs as a consequence of orgasm.

Although contemporary Western culture tends to idealize dramatic “cum“ explosions, Taoist and Tantric sexual practices endorse periodic semen retention as a legitimate alternative. Instead of viewing ejaculation, orgasm, or even intercourse, as the ultimate goal, Tantric and Taoist sex focuses on building intimacy and sexual energy. If your partner wants to learn how to screw like Sting, he can check out The Multiorgasmic Man, The Tao of Love and Sex, or The Complete Idiot’s Guide to Tantric Sex.

Medical treatment options, for those who prefer Big Pharma to the Kama Sutra, have included the use of selective serotonin reuptake inhibitors (e.g. Prozac, Celexa, Paxil), to mitigate the intensity of post-coital letdown, and non-steroidal anti-inflammatory drugs, taken before and after sexual activity, to prevent an autoimmune response. The most recent research study, conducted by Dr. Marcel Waldinger, in 2011, found hyposensitization therapy to be effective, which appears to support the allergy hypothesis.

While I hope this information proves helpful, the fact that “he has decided that celibacy is the only solution” should be discussed, as, ideally, both partners are involved in making decisions that involve sex and intimacy. Furthermore, does “celibacy” mean that he is opposed to ALL forms of sexual activity? There are several viable alternatives to standard intercourse, many of which do not require ejaculation. If your partner is withdrawing more than his semen—neglecting your emotional and physical needs, or failing to show interest and affection altogether—it might be time to engage in further dialogue about the relationship, and whether your desires can be satisfied.